Clinical features of myasthenia gravis patients with autoimmune thyroid disease in Taiwan
Clinical features of myasthenia gravis patients with autoimmune thyroid disease in Taiwan
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DOI：
10.1111/j.1600-0404.2012.01693.x
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发表时间：
2013-03-01
影响因子：
3.5
通讯作者：
Chiu, H-C
中科院分区：
文献类型：
--
作者：
Chen, Y-L;Yeh, J-H;Chiu, H-C
目的分析伴或不伴自身免疫性甲状腺疾病（ATD）的重症肌无力（MG）患者的患病率和临床特征。材料与方法回顾性分析1999 ~ 2009年1482例MG患者的临床资料。根据甲状腺评估以及神经学、临床和血清学结果，将患者分为A组（伴有ATD的MG患者）或B组（不伴有ATD的MG患者）。当患者的眼部系统症状持续2年或更长时间时，将其归类为眼肌无力。结果1482例MG患者中，A组121例（8.2%）; Graves病（5.7%）高于桥本甲状腺炎（1.1%）和抗体阳性甲状腺疾病（1.4%）。伴有ATD的MG患者主要为女性，MG症状发作时较年轻，轻度MG（眼部和轻度全身性MG）和胸腺增生的发生率较高，血清阳性抗乙酰胆碱受体抗体水平较低。与无甲状腺眼病的患者相比，有甲状腺眼病的ATD患者发生眼MG的频率更高。结论这是迄今为止对伴有和不伴有ATD的MG患者临床特征的最大综述。我们发现，与眼MG相比，轻度MG更常与ATD相关。此外，我们观察到胸腺增生在伴有ATD的MG患者中更常见，而胸腺瘤在没有ATD的MG患者中更常见。
Objectives The aim of this study was to analyze the prevalence and clinical features of myasthenia gravis (MG) patients with and without autoimmune thyroid disease (ATD). Materials and methods Between 1999 and 2009, we reviewed a total of 1482 patients with MG. On the basis of thyroid evaluations, as well as neurological, clinical, and serological findings, the patients were divided into group A (MG patients with ATD) or group B (MG patients without ATD). The patients were categorized as having ocular myasthenia when symptoms restricted to the ocular system were present for 2years or more. Results Of the 1482 MG patients, 121 (8.2%) patients were classified into group A. Graves' disease was more predominant (5.7%) than Hashimoto's thyroiditis (1.1%) and antibody-positive thyroid disease (1.4%). MG patients with ATD were predominantly female, were younger at the onset of MG symptoms, had a higher frequency of mild MG (ocular and mild generalized MG) and thymic hyperplasia, and had lower levels of seropositive anti-acetylcholine receptor antibodies. Compared to patients without thyroid eye disease, ATD patients with thyroid eye disease had a higher frequency of ocular MG. Conclusions This is the largest review of the clinical features of MG patients with and without ATD to date. We found that compared to ocular MG, mild MG is more commonly associated with ATD. Furthermore, we observed that thymic hyperplasia is more common in MG patients with ATD, while thymoma is more common in MG patients without ATD.